
ABSTRACT Background A very high‐power short‐duration (vHPSD) radiofrequency (RF) ablation creates shallower lesions, which may be insufficient in thick myocardial regions. Aims To clarify an effective ablation strategy following the initial vHPSD application and determine the best approach to create sufficient lesion depth in thick myocardial regions using ex vivo and in vivo models. Methods Lesion metrics were compared under various settings: 35 W versus 50 W with the same target ablation index (AI) (Step 1); double vHPSD ablations versus vHPSD followed by AI‐guided ablation (Step 2); double applications (DA) with vHPSD followed by AI‐guided ablation with a target AI of 450 versus single application (SA) with a target AI of 550 at 50 W (Step 3). Results Lesion depth was comparable between groups with the same AI but different RF powers. Lesions were significantly deeper in the vHPSD ablation followed by a target AI of 450 compared to double vHPSD ablations (vHPSD + vHPSD, 3.4 [3.1–3.6] mm; vHPSD + AI 450 at 35 W, 4.4 [4.1–4.9] mm; vHPSD + AI 450 at 50 W, 4.5 [4.1–4.9] mm, p < 0.001). High‐power SA with a target AI of 550 created significantly deeper lesions than vHPSD + AI 450 (DA vs. SA, 4.5 [3.5–5.3] mm vs. 5.0 [4.1–5.9] mm, p = 0.01). Conclusions AI‐guided RF applications following vHPSD effectively increased lesion depth more than repeated vHPSD. However, a single high‐power application targeting a higher AI resulted in the deepest lesions. This strategy may be particularly beneficial in thick atrial myocardial regions to enhance lesion durability and improve procedural outcomes.
Time Factors, Swine, Myocardium, Catheter Ablation, Animals, Action Potentials, Original Article
Time Factors, Swine, Myocardium, Catheter Ablation, Animals, Action Potentials, Original Article
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 0 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
